Posttraumatic stress disorder (PTSD) is associated with myriad relationship problems and psychological distress in partners of individuals with PTSD. This study sought to develop a self-report measure of partner accommodation to PTSD (i.e., ways in which partners alter their behavior in response to patient PTSD symptoms), the Significant Others' Responses to Trauma Scale (SORTS), and to investigate its reliability and construct validity in 46 treatment-seeking couples. The SORTS demonstrated strong internal consistency and associations with individual and relationship distress. Accommodation was positively correlated with partners' ratings of patients' PTSD symptoms, patient self-reported depressive and trait anger severity, and partner self-reported depressive and state anger severity. Accommodation was negatively correlated with patient and partner relationship satisfaction and partners' perceived social support received from patients. Findings suggest that accommodation may be an attempt to adapt to living with a partner with PTSD but may have negative implications for patient and partner well-being.
Global Collaboration on Traumatic Stress (GC-TS) (2020) Screening for consequences of trauma-an update on the global collaboration on traumatic stress,
Psychedelic therapy shows promise as a novel intervention for a wide range of mental health concerns but its therapeutic action is incompletely understood. In line with acceptance and commitment therapy's (ACT's) transdiagnostic model, qualitative research has suggested that reductions in experiential avoidance are an important component of therapeutic outcomes associated with psychedelics. However, limited research has quantitatively explored the association between decreases in experiential avoidance and therapeutic outcomes associated with psychedelics. Therefore, in two prospective studies, using convenience samples of individuals with plans to use a psychedelic, we explored the impact of psychedelic use on experiential avoidance, depression severity, and suicidal ideation, as well as relationships between changes in these outcomes. Participants (Study 1, N=104; Study 2, N=254) completed self-report questionnaires of depression severity, suicidal ideation, and experiential avoidance: 1) before using a psychedelic (in ceremonial and non-ceremonial contexts), as well as 2) 2weeks and 3) 4-weeks after psychedelic use. Across both studies, repeated measures ANOVAs indicated significant decreases in experiential avoidance, depression severity, and suicidal ideation after psychedelic use. Furthermore, decreases in experiential avoidance were significantly associated with decreases in depression severity and suicidal ideation. These results suggest that psychedelics may lead to significant decreases in experiential avoidance, depression severity, and suicidal ideation. Additionally, these findings imply that reduced experiential avoidance may be a transdiagnostic mechanism mediating treatment success within psychedelic therapy. We conclude that integrating psychedelics with psychotherapeutic interventions that target experiential avoidance (e.g. ACT) may enhance therapeutic outcomes.
HIV stigma is a pressing concern for people living with HIV, and particularly when it is perpetuated by health care providers, as it may affect quality of life and access to health care services. The current study describes the development and initial validation of a contextually appropriate HIV stigma scale for health care providers in North America. A ground-up qualitative approach was used to develop the scale, and it was assessed psychometrically with health care trainees across Canada. The measure demonstrates excellent internal consistency reliability and test-retest reliability, as well as convergent and divergent validity. The study supports a tripartite model of HIV stigma consisting of stereotyping, prejudice and discrimination. The scale provides a new tool to assess HIV stigma in health care providers and can be used to inform training, intervention and self-evaluation of stigmatizing attitudes, beliefs and behaviors among providers.
Objective
Partner accommodation of posttraumatic stress disorder (PTSD) symptoms (i.e., altering one’s own behaviors to minimize patient distress and/or relationship conflict due to patients’ PTSD symptoms) has been shown to be positively associated with patient and partner psychopathology and negatively associated with patient and partner relationship satisfaction cross-sectionally. However, the prognostic value of partner accommodation in treatment outcomes is unknown. The goals of the present study were to determine if partner accommodation decreases as a function of couple therapy for PTSD and if pretreatment partner accommodation moderates the efficacy of couple therapy for PTSD.
Method
Thirty-nine patients with PTSD and their intimate partners (n = 39) were enrolled in a randomized controlled trial of cognitive-behavioral conjoint therapy (CBCT) for PTSD (Monson & Fredman, 2012) and received CBCT for PTSD immediately or after three months of waiting. Blinded assessors determined clinician-rated PTSD symptoms and patient-rated PTSD and depressive symptoms and relationship satisfaction at baseline, mid-treatment/4 weeks of waiting, and posttreatment/12 weeks of waiting.
Results
Contrary to expectation, partner accommodation levels did not change over time for either treatment condition. However, baseline partner accommodation significantly moderated treatment outcomes. Higher levels of partner accommodation were associated with greater improvements in PTSD, depressive symptoms, and relationship satisfaction among patients receiving CBCT for PTSD compared with waiting list. At lower levels of partner accommodation, patients in both groups improved or remained at low levels of these outcomes.
Conclusions
Individuals with PTSD who have more accommodating partners may be particularly well-suited for couple therapy for PTSD.
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